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Course Description

This course will focus on the final processes of revenue cycle management. Topics covered are remittance processing, insurance follow-ups, collection of payments from third-party insurers, denials management, creation and submission of bills to patients and working with the patients to collect the full financial responsibility. Students will also explore the purpose and importance of utilization review. Students will connect the functions covered in the course to the complete revenue cycle and health information management operations. This training requires completion of Training Parts 1 and 2 or mid-level revenue cycle awareness/experience.

Learner Outcomes

  • Perform accurate claims creation
  • Explain the process for creating and sending a bill to patients
  • Discuss the steps to take in corresponding with third-party insurers
  • Describe ways to prevent claims denials and actions to take in response to a denial
  • Create a patient collections letter
  • Describe the process of posting payments and adjustments
  • Define utilization review and explain its importance
  • Describe how this level of the revenue cycle has a direct connection with health information management operations.
  • Demonstrate professional communication and behavior.

Prerequisites

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